Navigating the complexities of dietary restrictions related to gluten can be challenging, especially when distinguishing between coeliac disease and gluten intolerance. While both conditions dictate a need for careful dietary management, they differ significantly in their origins, symptoms, and treatment approaches. This blog aims to elucidate these differences and explore how those with gluten intolerance might improve their tolerance over time.
What is Coeliac Disease? Coeliac disease is a chronic autoimmune condition triggered by the ingestion of gluten, a protein found in wheat, barley, and rye. In individuals with coeliac disease, gluten exposure leads to immune-mediated damage to the small intestine, impairing nutrient absorption and leading to a range of gastrointestinal and systemic symptoms. Diagnosis is confirmed through specific blood tests and an intestinal biopsy. Managing coeliac disease requires a strict, lifelong avoidance of gluten.
What is Gluten Intolerance? Also known as non-coeliac gluten sensitivity, gluten intolerance describes a condition where individuals experience symptoms similar to those of coeliac disease upon consuming gluten, but without the associated autoimmune intestinal damage. Symptoms, which can include bloating, diarrhoea, and abdominal pain, typically resolve on removing gluten from the diet. Unlike coeliac disease, gluten intolerance does not usually cause long-term harm to the body, and testing for it mainly rules out coeliac disease.
Differences in Treatment and Management:
- Coeliac Disease: The only effective treatment is a strict, lifelong gluten-free diet. Even small amounts of gluten can cause significant health issues, so vigilance is crucial.
- Gluten Intolerance: Individuals may be able to manage symptoms by reducing gluten intake rather than eliminating it entirely. Some people may also find that they can reintroduce gluten into their diet gradually, as their tolerance improves over time.
Improving Gluten Tolerance: For those with gluten intolerance (not coeliac disease), there may be potential to increase gluten tolerance gradually. This should be attempted under the guidance of a healthcare professional to monitor symptoms and responses. The approach typically involves:
- Gradual reintroduction: Starting with very small amounts of gluten and slowly increasing the quantity if no adverse effects are experienced.
- Dietary support: Incorporating foods that support gut health, such as probiotics and prebiotics, may help improve the gut’s ability to handle gluten.
- Monitoring and adjustment: Keeping a food diary and noting any symptoms can help tailor the gluten reintroduction process to individual tolerances.
Understanding the distinctions between coeliac disease and gluten intolerance is crucial for effective management and maintaining good health. While individuals with coeliac disease must avoid gluten for life, those with gluten intolerance may have the potential to reintroduce gluten gradually, though this must be done cautiously and under professional supervision to ensure it does not lead to discomfort or health issues.
If you suspect you have a gluten-related disorder, it’s important to seek professional medical advice before altering your diet. Have you tried managing or reintroducing gluten into your diet?
NB: This blog provides clear distinctions between coeliac disease and gluten intolerance, alongside practical advice for potentially increasing gluten tolerance, all tailored for readers who may be exploring how to manage their sensitivity to gluten.
At home with Mrs E 